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Liver

Alkaline phosphatase (ALP) in men: the limit, the liver and what the value says

According to the Cleveland Clinic, the liver is where alkaline phosphatase is primarily found, which is why it is often considered a liver enzyme, although it also exists in the bones, bile ducts, kidneys and intestines. According to the Cleveland Clinic, an enzyme is a protein that acts as a catalyst and so lets processes in the body happen.

According to the Cleveland Clinic, a high value may indicate liver disease such as hepatitis or cirrhosis, or a bone disorder; according to that source, between 15 and 50 the value is slightly higher in men than in women. Only a blood test gives the value.

Certe uses less than 115 U/l for men above 19.

Doctor's Assessment Included

Alkaline phosphatase is an enzyme that in the blood comes mainly from the liver and the bones. According to the Cleveland Clinic, a high value may indicate liver disease or a bone disorder, a low value malnutrition, among other things.

  • For alkaline phosphatase, Star-SHL and Unilabs use 45 to 128 U/l for men aged 19 to 50 inclusive and 38 to 123 U/l for women of that age.
  • For alkaline phosphatase, Certe uses less than 115 U/l in men and less than 98 U/l in women above 19; Diagnostiek voor U 40 to 120 U/l above 18.
  • According to the Cleveland Clinic, an isoenzyme test can show whether alkaline phosphatase comes from the liver or the bones.

Reference Ranges

See the value that applies to you:

Choose male or female — this range differs by sex.

Enter your age — this range changes with age.

This range also depends on context such as cycle phase or sample material; the highlighted rows apply to your group.

Your reference range
u/l
44 190 u/l
Reference ranges by group, in u/l
Male · 13–18 years 63–190 u/l
63 190
Male · 19–50 years 45–128 u/l
45 128
Male · 51–65 years 46–126 u/l
46 126
Male · 66–80 years 44–134 u/l
44 134
Male · 81 years and older 45–145 u/l
45 145
44 190 u/l

Source: NVKC Reference population: Dutch general-practice population (NUMBER, n = 7,574,327)

Reference ranges may vary between laboratories. When you order a test, a BIG-registered doctor assesses your personal results in context. For treatment decisions, discuss your results with your GP.

Check your own value

ALP (Alkaline Phosphatase): what Dutch laboratories use

Reference ranges by group, in u/l
Star-shl · Male · 19–50 years 45–128 U/l
45 128
Star-shl · Male · 51–65 years 46–126 U/l
46 126
Star-shl · Male · 66–80 years 44–134 U/l
44 134
Star-shl · Male · 81 years and older 45–145 U/l
45 145
Unilabs · Male · 19–50 years 45–128 U/l
45 128
Unilabs · Male · 51–65 years 46–126 U/l
46 126
Unilabs · Male · 66–80 years 44–134 U/l
44 134
Unilabs · Male · 81 years and older 45–145 U/l
45 145
Certe · Male · 19 years and older · a limit, not a range < 115 U/L
115
Diagnostiek voor U · Everyone · 19 years and older 40–120 U/L
40 120
0 159.5 u/l

Source: Star-shl

Source: Unilabs

Source: Certe

Source: Diagnostiek voor U

Each value as the laboratory itself publishes it, retrieved in 2026.

ALP (Alkaline Phosphatase): what this test measures

An ALP test measures in U/l the alkaline phosphatase in the blood; Certe measures it enzymatically and names the publication CCLM 2011;49:1439-46 as its source for adults.

ALP (Alkaline Phosphatase): why this value matters

Hepatitis, cirrhosis and a narrowed bile duct or one blocked by cancer can, according to the Cleveland Clinic, give a high alkaline phosphatase from the liver, which is why this value counts for the liver.

ALP (Alkaline Phosphatase): how the blood test works

Referral
No GP referral needed. After the order we arrange the referral through ZorgDomein, within one business day; orders after 17:00 or at the weekend start on the next business day. ZorgDomein emails a barcode, and that barcode is what the draw site needs.
The draw
A blood draw from a vein in the arm, at a partner laboratory's draw site. No home kit, no finger prick.
Which test
Complete Metabolic Panel · €149,-
Where
650+ draw sites run by independent laboratories across the Netherlands. Draw sites

ALP (Alkaline Phosphatase): when is testing worthwhile?

According to the Cleveland Clinic, an ALP test can monitor an existing liver or bone condition, to see whether it is improving, worsening or staying the same.

ALP (Alkaline Phosphatase): symptoms of a high or low value

Low Levels

According to the Cleveland Clinic, an alkaline phosphatase that is abnormally low can go with rare genetic conditions such as hypophosphatasia and Wilson disease, alongside malnutrition and a zinc or magnesium deficiency.

High Levels

According to the Cleveland Clinic, hepatitis, cirrhosis, a narrowed bile duct and a bile duct blockage caused by cancer are liver causes of a high alkaline phosphatase. According to that source, with a mild rise the provider will likely first monitor the value over time.

ALP (Alkaline Phosphatase): causes of a low or high value

What lowers the value

  • Malnutrition

    Malnutrition may lie behind a low alkaline phosphatase, which is less common than a high one.

  • Zinc or magnesium deficiency

    A zinc deficiency or a magnesium deficiency may cause a low alkaline phosphatase.

  • Underactive thyroid (hypothyroidism)

    An underactive thyroid may cause a low alkaline phosphatase.

  • Rare genetic conditions, such as hypophosphatasia

    Rare genetic conditions, including hypophosphatasia and Wilson disease, may cause a low alkaline phosphatase.

What raises the value

  • Narrowed or blocked bile ducts

    A narrowed bile duct, or a bile duct blocked by cancer, may cause a high alkaline phosphatase from the liver.

  • Hepatitis or cirrhosis of the liver

    Hepatitis, an inflammation of the liver, and cirrhosis may cause a high alkaline phosphatase.

  • Cholestasis of pregnancy

    Cholestasis of pregnancy is a liver disease that can develop late in pregnancy and may cause a high alkaline phosphatase.

  • Healing fracture

    A fracture that is healing may cause a high bone alkaline phosphatase.

  • Bone disorders such as Paget's disease or osteomalacia

    Paget's disease, a rare chronic bone disorder, and osteomalacia, which weakens the bones, may cause a high bone alkaline phosphatase.

ALP (Alkaline Phosphatase): lifestyle and this value

With a raised alkaline phosphatase, according to the Cleveland Clinic a provider may order additional tests, such as an isoenzyme test, to show whether the extra enzyme comes from the liver or from the bones. Discuss the result with your GP.

ALP (Alkaline Phosphatase): frequently asked questions

Do men have a higher alkaline phosphatase than women?

According to the Cleveland Clinic, between 15 and 50 alkaline phosphatase is slightly higher in men than in women, and above 19 Certe uses less than 115 U/l for men and less than 98 U/l for women.

ALP (Alkaline Phosphatase): sources

  1. den Elzen WPJ, Brouwer N, Thelen MH, Le Cessie S, Haagen I-A, Cobbaert CM. NUMBER: standardized reference intervals in the Netherlands using a 'big data' approach. Clin Chem Lab Med 2018;57(1):42-56. (retrieved 2026) doi.org
  2. Star-shl, Labbepalingen (referentiewaarden per bepaling), star-shl.nl, geraadpleegd 2026-10-01 (retrieved 2026) star-shl.nl
  3. Diagnostiek voor U, eLabgids (Referentiewaarden DvU), diagnostiek.getincontrol.eu, geraadpleegd 2026-10-01 (retrieved 2026) diagnostiek.getincontrol.eu
  4. Certe, Bepalingenwijzer (referentiewaarden per bepaling), bepalingenwijzer.certe.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenwijzer.certe.nl
  5. Unilabs, Bepalingenklapper (referentiewaarden per bepaling), bepalingenklapper.nl, geraadpleegd 2026-10-01 (retrieved 2026) bepalingenklapper.nl
  6. Cleveland Clinic Health Library, Alkaline Phosphatase (ALP), my.clevelandclinic.org, geraadpleegd 2026-10-18 (retrieved 2026) my.clevelandclinic.org

Test Products

This marker is included in the following test panels.

Heart and blood vessels

Complete Metabolic Panel

Comprehensive metabolic panel: electrolytes, kidney, liver, glucose, HbA1c, and protein.

HbA1c (Glycated Hemoglobin) ALT (Alanine Aminotransferase) Calcium ALP (Alkaline Phosphatase) AST (Aspartate Aminotransferase) Bilirubin (Total) Urea (BUN) Creatinine eGFR (Estimated Glomerular Filtration Rate) Glucose (Fasting) Bicarbonate Chloride Sodium Potassium Albumin Total Protein Bilirubin (Direct) Bilirubin (Indirect)
€149,-

Medical reviewer

Medical standards

Dr. Naimi oversees the medical standards behind our content and assessments.

Medical policy
CIBG Ministerie van Volksgezondheid,
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ALP (Alkaline Phosphatase)

€8,-